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41 Second, because postoperative S-1 chemotherapy for stages IIIA and IIIB did not significantly improve survival in the subgroup analysis of the ACTS-GC study, 1 preoperative cisplatin-based chemotherapy for downstaging and potential early elimination of circulated cancer cells 2 could be considered, although no subgroup analysis from the MAGIC trial is available.
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First, surgical manipulation of the tumour and its vascular supply may mechanically introduce circulating cancer cells into the circulation [ 52].
Endothelial tight junctions act as a natural barrier for the vascular spread of cancer cell, by keeping the circulating cancer cells 'at bay-in the circulation'.
The vast majority of circulating cancer cells don't do anything.
Circulating cancer cells often establish new tumours "downstream" from their originating organ.
Circulating cancer cells often establish metastases "downstream" from their originating organ.
Circulating cancer cells are well documented.
Another issue is the presence of circulating cancer progenitor cells.
It is well established that many cancer patients have circulating cancer cells[47, 48].
Fig. 1 Schematic of current approaches for the detection of circulating cancer cells.
Rather, circulating cancer cells in an inflammatory environment extravasate, resulting a number of months later in a metastatic tumor.
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